What should I do if anal fissures keep recurring?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 05, 2024
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Repeated episodes of anal fissure generally result in the formation of chronic anal fissures. The fissure in chronic anal fissures mainly presents as an ulcer surface, and because the fissure is enclosed within the local sphincter muscles, drainage is poor, thus reducing the likelihood of healing.

When patients with anal fissures suffer from long-term recurrent episodes, they also experience spasms of the local anal sphincter and tightening of the anal canal, which can lead to difficulties in bowel movements and dry stools in the anal region. When the spasm of the local anal sphincter worsens, the pain may cause patients to be afraid of defecating voluntarily, thereby creating a vicious cycle of recurrent episodes. The best treatment for recurrent chronic anal fissures is surgical intervention.

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Can anal fissures be cured completely?

Anal fissures are a curable condition, so do not worry. Anal fissures are relatively common in clinical practice and are a frequently occurring disease. Fresh anal fissures, which are of short duration and have small fissures, can be treated and cured using methods such as fumigation, oral medications, or rectal insertion. For older, chronic anal fissures, surgical treatment can be administered, including methods like the Milligan-Morgan technique or fissurectomy, all of which can achieve a cure. However, anal fissures are related to lifestyle and dietary habits, so even after healing, it is important to be cautious of various triggering factors to prevent recurrence.

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Written by Yu Xu Chao
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How to treat anal fissure bleeding

For early anal fissure bleeding, the first step is to soften the stool by eating more foods high in rough fiber to maintain smooth bowel movements as much as possible. This prevents hard and dry stools from irritating the fissure, causing bleeding or worsening pain. Additionally, after defecating, it is necessary to take a sitz bath using warm saltwater or an anal cleansing solution. It is generally recommended to sitz bath for five to six minutes, which can have anti-inflammatory and hemostatic effects. After the sitz bath, apply Dragon Ball ointment or nitroglycerin ointment locally to promote ulcer healing. Typically, symptoms can significantly improve within seven to ten days of medication. However, if the patient has chronic anal fissure with prolonged pain after each bowel movement, surgical treatment is needed due to fibrous scar formation in the internal anal sphincter. In such cases, an anal fissure excision surgery might be undertaken, followed by dressing changes using medications like red oil ointment gauze or golden ointment. (Please follow medical advice regarding medication.)

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Written by Hu Xiang Dang
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What should be paid attention to usually for anal fissures?

What should I pay attention to for anal fissures? Friends who suffer from anal fissures should note the following: Firstly, pay attention to your diet. Adjust your diet structurally to be diverse. Drink plenty of water and eat less spicy and stimulating food; abstain from alcohol and betel nuts; eat less spicy hot pot and similar foods. Also, maintain a smooth bowel movement. We should develop a habit of defecating regularly, and treat constipation correctly. However, in treating constipation, we should not misuse laxatives and should use medications under the proper guidance of a doctor. We should also pay attention to keeping the anal area clean and hygienic by washing it after each bowel movement. After defecation, it is best to perform sitz baths using salt water, traditional Chinese medicine pain relievers like Shen Tang, or potassium permanganate solution. This helps in the recovery of the anal fissure. In addition to the above, we should also engage in appropriate activities. Friends with anal fissures can perform anal muscle contractions, such as Kegel exercises or stretching exercises.

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Written by Hu Xiang Dang
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Is anal fissure serious?

People often ask whether anal fissures are serious and what the consequences might be if they are not treated. Although treating anal fissures is not particularly difficult clinically, many patients, due to a lack of treatment knowledge and awareness of the condition, often delay treatment, which can cause some harm to their health. If an anal fissure is not treated, in addition to the pain during bowel movements and bleeding that the fissure itself causes, over time, it could also lead to conditions such as anal fistula and hypertrophied anal papillae. At the end of the fissure, a sentinel pile may develop. Due to the repeated irritation by fecal matter in an inflamed fissure, a linear ulcer may form. The skin and subcutaneous tissue around the anus might undergo fibrosis, thickening, or. form a hard lump. If the fissure repeatedly becomes infected, it can lead to the development of an anal sinus, and after infection, it may cause subcutaneous fistulas or abscesses. Of course, if an anal fissure persists over time, due to long-term spasm and fibrosis of the internal sphincter, it can lead to consequences such as anal stenosis.

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Anal fissures occur in which part?

Anal fissures are an extremely common condition in proctology. They occur in the fragile and narrowest tissue of the anal canal due to the combined effect of various internal and external factors, leading to the opening and cracking of the digestive tract outlet up to the dentate line and the surface of the anal margin. The oval-shaped small ulcers that form from anal fissures usually occur at the anal region, aligning parallel to the longitudinal direction of the anal canal. The condition is often recurrent and difficult to heal. The angle continuation between the anal canal and the rectum means that the posterior wall of the anal canal is under the most pressure during bowel movements. Therefore, the posterior midline is most susceptible to injury and is also the most common site for the occurrence of anal fissures.